Researchers have taken an emotional look at the brains of people with bipolar disorder and found a difference between them and healthy brains. A study in the journal Molecular Psychiatry explains that the affected brains — from young people with bipolar disorder and those at high risk for the mental illness — had weaker connections in important emotional regions.

Unusual connections in different brain networks have been linked to other psychiatric disorders like schizophrenia, depression and attention-deficit hyperactivity disorder. “Even subtle perturbations to brain networks can cause disturbances in cognitive and emotional processes, particularly if they target highly connected hubs in executive, emotional and association regions,” the study says. And schizophrenia and bipolar disorder have been shown to have a “substantial genetic overlap.”

However, unlike in schizophrenia, in bipolar brains “the structural core of the brain remains intact.” The study notes that this might be a “key neurobiological difference between the disorders.”

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Bipolar disorder, previously known as manic depression because it causes alternating periods of euphoria and despondency, currently cannot be diagnosed with brain imaging. Doctors may identify signs such as the mood swings, irritability, promiscuity and other risky behavior, trouble concentrating, or changes in eating patterns. But it can be hard to distinguish from schizophrenia if it presents with hallucinations or delusions or from normal mood changes in brooding adolescents.

The researchers from the University of New South Wales (UNSW) and the QIMR Berghofer Medical Research Institute, both in Australia, hope that their findings about a bipolar brain’s structure will help doctors better identify the disorder in patients and “manage those at risk before the onset of the disorder and help reduce its impact once it develops,” according to a UNSW statement.

“Many people are incorrectly diagnosed with depression or other disorders,” researcher Michael Breakspear, from QIMR Berghofer, said in the statement. “This delays the start of proper treatment with medications that are specific to bipolar disorder. Bipolar has the highest suicide rate of any mental illness, so it’s crucial that we diagnose people correctly straight away so they can start receiving the right treatment.”

If we can identify people who are at risk for developing the disease, we can advise them on how to limit that risk, such as by avoiding drug use and intense stress.

“These discoveries may open the door to starting people on medication before the illness, to reduce the risk of manic episodes before the first one occurs,” Breakspear said.

Source: Breakspear M, Roberts G, Perry A, et al. Structural dysconnectivity of key cognitive and emotional hubs in young people at high genetic risk for bipolar disorder. Molecular Psychiatry. 2016.

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Understanding How a Mentally Ill Brain Works